There is perhaps no more complex system than an academic medical center. Although implementing the Chronic Care Model in this environment is extremely challenging, it is also very rewarding.

Academic physicians work within multiple missions that include the expectation of promotion and academic success in addition to the delivery of excellent care. The academic teaching environment also brings with it the ability to stay current and to demonstrate and promote evidence-based medical decisionmaking.

These high-performing Academic Chronic Care Collaborative teams were able to overcome the barriers presented by their large bureaucracies and align the differing roles within the programmatic and care environments to successfully implement and sustain the Chronic Care Model. They also created a culture of innovation by overcoming fear of failure, reinforcing improvement behavior, and gathering data efficiently to demonstrate success and identify new areas for change.

By engaging residents in the process, the teams established effective communication and coordination systems, and residents embraced the Chronic Care Model as their own.